Taking the Plunge – to go PUMP or no PUMP – a typical type 1 dilemma?

insulin pump

The decision of whether to use an insulin pump or not is indeed a typical dilemma faced by many individuals with type 1 diabetes. Both insulin pump therapy and multiple daily injections (MDI) have their pros and cons, and the choice ultimately depends on the individual’s lifestyle, preferences, and healthcare needs. In South Africa there are in the main, 2 insulin pump systems readily available. We have the Medtronic 780G insulin pump, and the Dexcom Tandem Control IQ insulin pump. Both of these have a strong presence on our market, and both companies offer nationwide patient pump support, through a network of trained insulin pump educators. Here are some factors to consider when making the decision to use an insulin pump.

Insulin Pump: Pros –

Continuous Insulin Delivery: Insulin pumps deliver a continuous supply of insulin, providing a more stable basal insulin profile compared to MDI.

Flexible Insulin Dosing: Pumps allow for more precise and flexible insulin dosing, making it easier to adjust insulin delivery based on factors like meals, physical activity, and illness.

Fewer Injections: Insulin pump users typically require fewer injections than those on MDI, as the insulin containing reservoir/cartridge only needs to be filled and replaced every few days.

Data Logging: Many modern insulin pumps come with data logging features, allowing users to track blood glucose levels, insulin doses, and carbohydrate intake conveniently. With the advent of smartphone and app technology, the advancement in tracking health markers is really changing how we view, and treat chronic conditions. Both insulin pumps available in South Africa enjoy seamless smart phone app integration.

Availability & Support: Both the insulin pump versions mentioned are readily available. Consumables and accessories for these insulin pumps systems are easily accessible online. Medical aids in South Africa are gradually beginning to warm to insulin pump use, and on motivation will enter into a part pay agreement with any Type 1 patient, who opts to start on an insulin pump therapy program.

Insulin Pump: Cons –

Cost and Maintenance: Insulin pumps can be expensive, and ongoing costs include infusion sets, reservoirs, and pump supplies.

Device Management: Wearing a pump requires managing the device, changing infusion sets, and handling potential technical issues.

Site Reactions: Some individuals may experience skin irritation or other site-related issues at the infusion site.

Accessibility: Pumps may not be easily accessible or affordable in some regions, especially in developing countries. (Does not apply South Africa)

Multiple Daily Injections (MDI): Pros –

Simplicity: MDI involves administering insulin through injections, which can be a more straightforward option for some individuals. Some individuals prefer to have this level of self-control

Cost: MDI is generally more affordable than insulin pump therapy.

No Device Wear: Some people prefer not to wear a pump and feel more comfortable with the simplicity of injections.

Multiple Daily Injections (MDI): Cons –

Injections Frequency: MDI involves multiple daily injections, which can be inconvenient for some individuals. Many injections could easily lead to tissue trauma at injection sites.

Less Precise Dosing: MDI may not offer the same level of precision and flexibility in insulin dosing as insulin pumps.

Lifestyle Limitations: MDI may pose challenges for those with irregular eating habits or varying activity levels.


So after reviewing all the pros and cons of Insulin pump therapy versus MDI, it is essential for individuals with type 1 diabetes to have an open and honest discussion with their Diabetes healthcare management team when deciding between insulin pump therapy and MDI. Factors such as lifestyle, insulin sensitivity, and hypoglycaemic event risk, budget, and personal preferences should all be taken into account. Ultimately, the goal is to choose the diabetes management approach that best supports the individual’s overall health and well-being.


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T/A The Centre Pharmacy

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Responsible Pharmacist: Imraan Ahmed Bismilla